The early postpartum period, specifically the first few weeks after delivery, is a time of high risk for a major depressive episode, also referred to as postpartum depression. During this time there is a heightened vulnerability for low mood due to postpartum blues. Severe postpartum blues may indicate the onset of postpartum depression (O'Hara et al., 1991). The sadness commonly observed around day-5 postpartum is considered in the healthy range of experience. However, it has also been observed that vulnerability to depressed mood is highly correlated to postpartum blues at day-5 and to exhibition of dysfunctional attitudes on day-5 postpartum (Dowlati et al, 2014). The neurobiological mechanisms leading to postpartum blues and postpartum depression are unclear.
Monoamine oxidase A (MAO-A) is a pro oxidant enzyme with the ability to metabolize monoamines such as serotonin, norepinephrine, and dopamine which help to maintain normal mood. Serotonin, norepinephrine, and dopamine levels are observed to be lowered during major depressive episodes. Elevated MAO-A levels are observed in individuals with major depressive disorder during a major depressive episode, and may contribute to monoamine-lowering observed during a major depressive episode in depressed individuals (Meyer et al., 2006; and Meyer et al., 2009).
Following delivery, estrogen levels typically drop 100- to 1000-fold during the first 3 to 4 days postpartum (O'Hara et al, 1996). Changes in estrogen levels have an inverse relationship with MAO-A levels (smith et al, 2004). Elevated MAO-A levels in early postpartum can serve as a marker of a monoamine-lowering process that contributes to mood changes associated with postpartum blues (Sacher et al., 2010).
Antidepressant medication can be utilized to address postpartum blues and postpartum depression. However, drug utilization carries with it concerns about side effects, and potential drug excretion into breast milk.
U.S. Pat. No. 6,083,526 (Gorach) suggests the use of a composition containing purified isoflavonoids, for example as derived from soy, for treating or preventing postpartum depression. The treatment purports to impart effect because of parallels between the chemical structure of isoflavonoids and estrogens, thus imparting an estrogen-like effect by increase of circulating isoflavonoids. No data is provided to illustrate any beneficial effect.
It has been suggested that dietary supplementation of tryptophan and tyrosine may be utilized to address postpartum blues or postpartum depression, as reported by Sullivan 2011, quoting J. H. Meyer at 4th World Congress on Women's Mental Health (Madrid). However no regime or illustration of efficacy was provided.
There is a need to address depressed mood arising in the postpartum period as well as depressed mood arising from other conditions associated with MAO-A levels. It is desirable to develop strategies that seek to address depressed mood.